Author/Editor		Agmon-Levin, Nancy; Rosário, C.; Porat-Katz, B; Zandman-Goddard, Gisele; Meroni, PierLuigi; Cervera, Ricard; Stojanović, Ljudmila; Blank, Miri; Pierangeli, Silvia S.; Praprotnik, Sonja
Title		Ferritin in the antiphospholipid syndrome and its catastrophic variant (cAPS)
Type		članek
Vol. and No.		Letnik 22, št. 13
Publication year		2013
Volume		str. 1327-1335
ISSN		0961-2033 - Lupus
Language		eng
Abstract		Background: Ferritin is an iron storage protein considered also as an acute phase reactant withhigh levels in various inflammatory conditions. Recently, a plausible role for ferritin in thepathogenesis of immune-mediated and especially autoimmune diseases has been suggested. However, the link between ferritin and the antiphospholipid syndrome (APS) has been rarelyexplored. Therefore, in the current study we evaluated ferritin levels and their correlation toclinical and serological manifestations in patients with APS. We further analyzed ferritin levelsamong patients with the catastrophic variant of APS (cAPS). Methods: Ferritin levels weredetermined in serum samples of 176 APS patients and 98 matched healthy controls accordingto age and sex (LIAISON, DiaSorin, Italy). APS samples were further analyzed for antiphospholipid(anti-cardiolipin, anti- beta-2-glycoprotein, lupus anticoagulant) and anti-infectiousantibodies (CMV, EBV, rubella, toxoplasma, HBV) (LIAISON, DiaSorin, Italy). Clinical,serological and demographic manifestations were recorded. An additional analysis of ferritinlevels among 14 patients with cAPS was performed. Results: Hyperferritinemia was present in9% vs. 0% of APS patients and controls, respectively (p<0.001). Among patients with APS,ferritin levels correlated with venous thrombosis, cardiac, neurological, and hematologicalmanifestations and the presence of anti-CMV-IgM antibodies. Hyperferritinemia was presentin 71% of cAPS patients, and ferritin levels among this subgroup were significantlyhigher compared with APS-non-cAPS patients (816847 ng/ml vs. 120230 ng/ml,p<0.001). Conclusions: Herein, we found that hyperferritinemia correlates with the presenceof APS, its clinical manifestations and specifically with the catastrophic variant of this disease. Hyperferritinemia was also linked with anti-CMV antibodies among patients with APS. Theseassociations allude to a pathogenic role of ferritin in the pathogenesis of APS, and the plausiblerole of ferritin as a marker of ensuing cAPS, although further studies are needed toelucidate these associations.
Keywords		ferritin antiphospholipid syndrome autoimmunity feritin antifosfolipidni sindrom avtoimunost